Center on Health Equity and Access

Clinical

Health Care Cost

Health Care Delivery

Insurance

Policy

Technology

Value-Based Care

News

All News

Partners

Press Releases

Product Approvals and Launches

Media

Clinical Spotlight

Enduring Webinars

Guidelines

Insights

Interviews

Medical World News

Microsites

News Network

OnLocation

Payer Perspectives

Peer Exchange

Podcasts

Post Conference Perspectives

Stakeholder Summit

Week in Review

Conferences

Conference Coverage

Conference Listing

Journals

Submit a Manuscript

All Journals

The American Journal of Managed Care

The American Journal of Accountable Care

Evidence-Based Oncology

Supplements and Featured Publications

Compendia

Asthma

Atopic Dermatitis

Biosimilars

Breast Cancer

COPD

COVID-19

Cholangiocarcinoma

Chronic Kidney Disease

Colorectal Cancer

DLBCL

Dermatology

Diabetes

Digital Health

Employers

Epilepsy

Heart Failure

Hematology

Hemophilia

Immuno-Oncology

Infectious Disease

Inflammation

Leukemia and Lymphoma

Liver

Lung Cancer

Lupus

Major Depressive Disorder

Medicare

Multiple Myeloma

Myasthenia Gravis

Myelodysplastic Syndromes

Oncology

Ophthalmology

Parkinson Disease

Prostate Cancer

Psoriasis

Pulmonary Arterial Hypertension

Rare Blood

Rare Disease

Reimbursement

Respiratory

Rheumatology

Skin Cancer

Sleep

Spinal Muscular Atrophy

Type 1 Diabetes

Vaccines

Women's Health

Events

Upcoming Webinars

CME/CE

Resources

Exclusive Content

Formulary Central

Interactive Tools

Subscribe

eNewsletter

Jaime is a freelance writer for The American Journal of Managed Care® (AJMC®), where she previously worked as an assistant editor.

She has a BA in print journalism from Penn State University. You can connect with Jaime on 

Articles

This analysis found that the 3000 patients with hemophilia had higher rates of pain, depression, and anxiety medication use.

Use of Pain, Depression, Anxiety Meds Higher Among Patients With Hemophilia

Former NBA star Magic Johnson has partnered with GSK to educate the public about this virus, specifically in seniors and those at high-risk for contracting a severe form of RSV.

 Raising Awareness About RSV in Older Adults

Mary is the associate editorial director for The American Journal of Managed Care® (AJMC®), The Center for Biosimilars®, and Evidence-Based Oncology™. She joined AJMC® in 2013 and oversees speaker recruitment and panel preparations for AJMC®'s premier annual oncology meeting, Patient-Centered Oncology Care®.

She has a BA in communications and philosophy from Loyola University New Orleans. You can connect with Mary on 

Based on promising results, the biotech IMV has moved into phase 2b trials with a cancer vaccine composed of survivin epitopes that uses the company’s proprietary delivery system to elicit persistent immune responses.

Delivery Matters: In Early Studies, DPX Technology Allows  Vaccines to Persist When Cancer Pushes Back 

Between 2019 and 2020, there were 97 reported shortages among sponsor-reported antiseizure medications in Australia, 93% of which were generic brands.

Shortages of Antiseizure Meds Continue, More Common Among Generics: Australian Report

The American Journal of Managed Care provides insights into the latest news and research in managed care across multimedia platforms.

About Us

Contact

Editorial Staff

Editorial Boards

Advertise

Do Not Sell My Information

Terms & Conditions

Privacy Policy

AJMC - Managed Care News, Research, and Expert Insights

Facebook

Twitter

LinkedIn

Stakeholders

Academia

Health System

Payers

Providers

Topics

Institute for Value-Based Medicine

All Coverage

Event Coverage

About AJMC

AJMC Journals

Anniversary

Author Forms

Authors

Nominate a Rising Leader

1rem

Compendium

Cholangiocarcinoma compendium is a comprehensive resource for clinical news and expert insights about this rare cancer of the bile duct.

—or biliary duct cancer—affects about 8000 US patients a year. On this episode of Managed Care Cast, we bring you an excerpt of an interview with Jesper B. Andersen, PhD, associate professor and group leader at the University of Copenhagen and the Biotech Research and Innovation center at the Department of Health.

There have been 3 FDA drug approvals for drugs that treat cholangiocarcinoma, but these therapies are only for patients who have certain mutations or rearrangements, signifying an unmet need, noted Andersen. And due to the limited number of patients, clinical trials are challenging.

Andersen was a co-chair of the 2022 Cholangiocarcinoma Foundation

 (CCF) annual conference, held earlier this year. 

 with Brielle Benyon, senior editor of CURE

You can watch the interview in its entirety on 

Listen above or through one of these podcast services:

On this episode of Managed Care Cast, we bring you an excerpt of an interview with a co-chair of the 2022 Cholangiocarcinoma Foundation (CCF) annual conference, held earlier this year, about the significant unmet therapy needs facing most patients with this rare cancer.

Understanding the Unmet Need for Therapies to Treat Rare Bile Duct Cancer 

Overall survival for patients with combined hepatocellular-cholangiocarcinoma is poor, but those who received adjuvant transarterial chemoembolization (TACE) after surgery had a prolonged recurrence-free survival (RFS).

Postoperative TACE Prolongs RFS in Patients With Combined Hepatocellular-Cholangiocarcinoma

Distal cholangiocarcinomas are rare, but clinicians can use a variety of imaging to diagnose it.

Case Report Details Diagnostic Imaging for Rare Distal Cholangiocarcinoma Case

Only 2% of patients with primary sclerosing cholangitis (PSC) received a  cholangiocarcinoma diagnosis, and the diagnosis was not early enough for there to be a survival benefit.

Surveillance Program Ineffective at Detecting Cholangiocarcinoma Early Enough for Benefit in Patients With PSC

Investigators also confirmed that FGFR2 fusion–positive tumors have a higher expression of FGFR2 but were not associated with higher expression of FGFR1, FGFR3, or FGFR4.

Study: FGFR mRNA Overexpression Occurs Frequently for Those With Cholangiocarcinoma

There are currently 3 FDA-approved therapies to treat cholangiocarcinoma with FGFR2 fusion or rearrangement, but these therapies face the development of resistance. Studies are underway to identify ways to overcome this resistance.

FGFR Inhibitors Show Promise in Cholangiocarcinoma but Face Acquired Resistance

Sunil Verma, MD, senior vice president and global head of oncology, medical, at AstraZeneca, talks about advancements in standards of care for uncommon cancers, including 

at the recent American Society of Clinical Oncology Gastrointestinal Cancers Symposium and discussed during the Cholangiocarcinoma Foundation 2022 meeting held February 23-25 in Salt Lake City, Utah, and virtually.

Why has it taken more than a decade to see major advancements in the standard of care in biliary duct cancer? Do you anticipate rapid uptake of the combination durvalumab plus a chemotherapy regimen of gemcitabine and cisplatin?

It's difficult to do trials for patients who have, what I would term, uncommon cancers. Biliary duct cancer is a type of cancer that is maybe in the forgotten category, where it doesn't get the same spotlight and limelight that some of the other cancers would get. As a result, the clinical trial infrastructure is not designed to offer clinical studies to our patients suffering from this disease. So I think this is a huge achievement, and kudos to the clinicians and investigators and everyone involved to really help those patients with cholangiocarcinoma so we can see these events.

Similar things have happened. I'm thinking back 20 years ago in lung cancer where clinical trials were not being done for lung cancer patients—they were the forgotten cancer patients. But when you start to see the development and advances, and it opens up even more studies being done, even more trials being done, I hope that will be the same for patients with biliary duct cancer, and this is the start of a momentum to build on even more advances in the future. I'm really proud of what the team has done to conduct such a trial [

], and I just hope that our work continues on as AstraZeneca and other pharma companies and other investigators and partners also then invest for these patients where the outcome remains poor. We have shifted that outcome where patients are now living longer, and we hope to continue to build on that.

The advances that are being seen in patients with liver cancer show our commitment for the organization, for GI [gastrointestinal] cancers. We continue to draw more trials and more studies because the outcome remains poor for many patients with GI cancers—gastric, liver, colorectal—and we are committed to doing more so more patients live longer and hopefully better.

Videos

Sunil Verma, MD, senior vice president and global head of oncology, medical, at AstraZeneca, talks about advancements in standards of care for uncommon cancers, including cholangiocarcinoma.

 Dr Sunil Verma on Advancements in Cholangiocarcinoma Standards of Care

Sunil Verma, MD, senior vice president and global head of oncology, medical, at AstraZeneca, discusses the safety findings of the TOPAZ-1 trial.

 at the recent American Society of Clinical Oncology Gastrointestinal Cancers Symposium and discussed during the Cholangiocarcinoma Foundation 2022 meeting held February 23-25 in Salt Lake City, Utah, and virtually.

Can you discuss the safety results in the TOPAZ-1 trial, which saw higher discontinuation rates for the chemo-only group?

So, when you see that, it suggests a couple of things. One, it tells you about the patient performance status and the patient's ability to tolerate a regimen, which may be directed by the tumor burden. When you see a response more in the combination where the patients are able to stay longer, that's telling us that the tumor burden starts to lessen where the patients are then able to stay on treatment and maintain on treatment much longer as a result. It's maybe less so the reflection of this traditional side effect profile, but it's more so a reflection of the side effect profile, along with an activity profile that allows the patient's performance status and quality of life to be better so that they can stay on treatment much longer, versus a patient who may be just on standard of care who is not driving the clinical benefit and, as a result, is maybe not able to tolerate the standard of care as effectively.

Sunil Verma, MD, senior vice president and global head of oncology, medical, at AstraZeneca, discusses safety findings of the TOPAZ-1 trial. 

Dr Sunil Verma Discusses Safety Findings of TOPAZ-1 Trial

Sunil Verma, MD, senior vice president and global head of oncology, medical, at AstraZeneca, discusses the addition of durvalumab to a chemotherapy regimen of gemcitabine and cisplatin for 

Can you discuss the mechanism of action of adding durvalumab to gemcitabine/cisplatin chemotherapy in biliary duct cancer?

What we have learned through many other tumor types—including lung cancer, breast cancer, and other emerging tumor types—in certain tumors, single-agent monotherapy IOs [immunotherapies] can be very effective. In melanoma, non–small cell lung cancer with high PD-L1 expression, single-agent monotherapy with IO was very effective.

But in many other tumors, which tend to be much more on the colder range, where the immune system is maybe not as activated, you need chemotherapy to trigger the immune cascade. We identified that biliary tract cancer was likely one of the tumors where we needed a chemotherapy foundation combination to trigger the immune cascade, which would then be enhanced with the combination of checkpoint inhibitors. So in this study, we had a chemotherapy foundation with cisplatin/gemcitabine, and then IO with durvalumab was added on top.

Sunil Verma, MD, senior vice president and global head of oncology, medical, at AstraZeneca, discusses the addition of durvalumab to a chemotherapy regimen of gemcitabine and cisplatin for biliary duct cancer.

 Dr Sunil Verma Discusses Adding Durvalumab to Cholangiocarcioma Chemotherapy Combination

Sunil Verma, MD, senior vice president and global head of oncology, medical at AstraZeneca, explains the background and results of the 

, which evaluated the use of immunotherapy to improve overall survival and progression-free survival of biliary tract cancer. Results were presented at the recent American Society of Clinical Oncology Gastrointestinal Cancers Symposium (ASCO GI). 

Can you discuss the purpose and results of the TOPAZ-1 study?

Let me start off by discussing biliary tract cancer. As you mentioned, hepatocellular cancer is also associated with delayed diagnosis and, similarly, with biliary tract cancer. These have very nonspecific symptoms where patients have some right upper abdominal pain, they may have some nausea, they may have some referred pain, and things that most people would suggest are nonspecific symptoms. Many of these patients are associated with very delayed diagnosis and, in biliary tract cancer, we have really not seen any major significant advances in this field for more than a decade, and the current main chemotherapy remains chemotherapy, and in most cases it is cisplatin- and gemcitabine-based chemotherapy. The trial TOPAZ-1 was looking to see, can we advance these outcomes for these patients with the use of immunotherapy? Patients were randomized to receiving cisplatin and gemcitabine, or cisplatin and gemcitabine plus durvalumab. Cisplatin and gemcitabine was given for a period of time, as is consistent traditional practice, and the durvalumab was continued until disease progression. The results, as shared at the ASCO GI meeting, suggest that there is a meaningful benefit in overall survival. I think that really is great news for patients and their families with this disease.

Sunil Verma, MD, senior vice president and global head of oncology, medical at AstraZeneca, explains the background and results of the TOPAZ-1 study.